SECOND EDITION
Editors Annamma Jacob MSc (N)
Professor, Bhagwan Mahaveer Jain College of Nursing Bengaluru, Karnataka, India
Formerly • Professor, St Philomina's College of Nursing, Mother Teresa Road, Bengaluru
• Principal, Graduate School for Nurses, BNE, SIB, CMAI
• Nurse Supervisor, Suburban Medical Center, Paramount, Southern California, USA
• Assistant Director of Nursing, Al-Sabah Hospital, Ministry of Public Health, Kuwait
• Sister Tutor, LT College of Nursing, SNDT Women's University, Mumbai, Maharashtra, India
• Junior Tutor, College of Nursing, CMC Hospital, Vellore, Tamil Nadu, India
Rekha R MSc (N)
Registered Nurse Medical-Surgical Department of Florida Medical Center Fort Lauderdale, Florida, USA
Formerly • Assistant Professor, Sree Mookambika College of Nursing Kanyakumari, Tamil Nadu, India
• Vice Principal, Bhagwan Mahaveer Jain College of Nursing Bengaluru, Karnataka, India
Jadhav Sonali Tarachand MSc (N) PG Diploma in Medical Law and Ethics
Associate Professor of Nursing Bhagwan Mahaveer Jain College of Nursing Bengaluru, Karnataka, India
Formerly • Lecturer in Medical-Surgical Nursing, St Martha's College of Nursing, Bengaluru, Karnataka, India
• Assistant Lecturer, Bharathi Vidyapeeth's College of Nursing, Pune, Maharashtra, India
Jitendar P Vij
Jaypee Brothers Medical Publishers (P) Ltd
Corporate Office
4838/24 Ansari Road, Daryaganj, New Delhi - 110002, India, Phone: +91-11-43574357, Fax: +91-11-43574314
Registered Office
B-3 EMCA House, 23/23B Ansari Road, Daryaganj, New Delhi - 110 002, India
Phones: +91-11-23272143, +91-11-23272703, +91-11-23282021
+91-11-23245672, Rel: +91-11-32558559, Fax: +91-11-23276490, +91-11-23245683
e-mail: jaypee@jaypeebrothers.com, Website: www.jaypeebrothers.com
Offices in India
- Ahmedabad, Phone: Rel: +91-79-32988717, e-mail: ahmedabad@jaypeebrothers.com
- Bengaluru, Phone: Rel: +91-80-32714073, e-mail: bangalore@jaypeebrothers.com
- Chennai, Phone: Rel: +91-44-32972089, e-mail: chennai@jaypeebrothers.com
- Hyderabad, Phone: Rel:+91-40-32940929, e-mail: hyderabad@jaypeebrothers.com
- Kochi, Phone: +91-484-2395740, e-mail: kochi@jaypeebrothers.com
- Kolkata, Phone: +91-33-22276415, e-mail: kolkata@jaypeebrothers.com
- Lucknow, Phone: +91-522-3040554, e-mail: lucknow@jaypeebrothers.com
- Mumbai, Phone: Rel: +91-22-32926896, e-mail: mumbai@jaypeebrothers.com
- Nagpur, Phone: Rel: +91-712-3245220, e-mail: nagpur@jaypeebrothers.com
Overseas Offices
- North America Office, USA, Ph: 001-636-6279734, e-mail: jaypee@jaypeebrothers.com, anjulav@jaypeebrothers.com
- Central America Office, Panama City, Panama, Ph: 001-507-317-0160, e-mail: cservice@jphmedical.com Website: www.jphmedical.com
Clinical Nursing Procedures: The Art of Nursing Practice
© 2010, Annamma Jacob, Rekha R, Jadhav Sonali Tarachand
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the editors and the publisher.
First Edition: 2007
Second Edition: 2010
9788184488104
Typeset at JPBMP typesetting unit
Printed at
6CONTRIBUTORS
- Anita Grace Daniel BSc (N)
- Asstt. Lecturer of Nursing
- Bhagwan Mahaveer Jain College of Nursing
- Bengaluru, Karnataka, India
- Annamma Jacob MSc (N)
- Professor, Bhagwan Mahaveer Jain College of Nursing
- Bengaluru, Karnataka, India
- Anne Dorcas BSc (N)
- Asstt. Lecturer of Nursing
- Bhagwan Mahaveer Jain College of Nursing
- Bengaluru, Karnataka, India
- Harsha Joy BSc (N)
- Asstt. Lecturer of Nursing
- Bhagwan Mahaveerr Jain College of Nursing
- Bengaluru, Karnataka, India
- Jadhav Sonali Tarachand MSc (N)
- PG Diploma in Medical Law and Ethics
- Associate Professor of Nursing
- Bhagwan Mahaveer Jain College of Nursing
- Bengaluru, Karnataka, India
- Jain Binny John BSc (N)
- Asstt. Lecturer of Nursing
- Bhagwan Mahaveer Jain College of Nursing
- Bengaluru, Karnataka, India
- Jessy Jacob MSc (N)
- Asstt. Professor of Nursing
- Bhagwan Mahaveer Jain College of Nursing
- Bengaluru, Karnataka, India
- Lakshmi BSc (N)
- Asstt. Lecturer of Nursing
- Bhagwan Mahaveer Jain College of Nursing
- Bengaluru, Karnataka, India
- Mary Daniel BSc (N)
- Asstt. Lecturer of Nursing
- Bhagwan Mahaveer Jain College of Nursing
- Bengaluru, Karnataka, India
- Nalini SR BSc (N)
- Asstt. Lecturer of Nursing
- Bhagwan Mahaveer Jain College of Nursing
- Bengaluru, Karnataka, India
- Naveena J BSc (N)
- Asstt. Lecturer of Nursing
- Bhagwan Mahaveer Jain College of Nursing
- Bengaluru, Karnataka, India
- Rekha R MSc (N)
- Registered Nurse
- Medical-Surgical Department of Florida Medical Center
- Fort Lauderdale, Florida, USA
- Sindhu Narendran BSc (N)
- Asstt. Lecturer of Nursing
- Bhagwan Mahaveer Jain College of Nursing
- Bengaluru, Karnataka, India
- Subha Shankari G BSc (N)
- Asstt. Lecturer of Nursing
- Bhagwan Mahaveer Jain College of Nursing
- Bengaluru, Karnataka, India
Nursing continues to be influenced by technology and a myriad of social, cultural, economic and environmental changes and nurses are challenged to maintain high levels of nursing knowledge and skills for meeting the acute care, long-term care and health promotion needs of individuals. Today's nurses ought to be particularly skilled in critical thinking and clinical decision-making as well as in consulting and collaborating with other members of the health care team.
In order to meet the challenges of the complex health care system, nurses must acquire the ability to provide skilled and compassionate nursing care in various stages of illness and across the age continuum.
This second edition of Clinical Nursing Procedures: The Art of Nursing Practice is intended to help student nurses as well as practicing nurses to carry out their roles and responsibilities within the complex system. The authors have made sincere and hard efforts to make the procedures in simple, easy-to-understand manner and in logical sequence. It is aimed at providing comprehensive coverage of the syllabus requirements of basic nursing courses.
We thank our publishers Jaypee Brothers Medical Publishers (P) Ltd for their timely efforts in producing quality books and reaching them to many users. Very special thanks to users who offered suggestions and careful critique, which motivated us to expand and reorganize the contents of this edition of the book.
Annamma Jacob
Rekha R
Jadhav Sonali Tarachand
10PREFACE TO THE FIRST EDITION
Today's nursing practice has evolved through many changes influenced by advances in science and technology which has made medical care more complex. As modalities for diagnosing and treating illnesses and managing patients in different stages of health-illness continuum change, several nursing procedures are added and rewritten.
Use of specialized equipments, articles and assisting with advanced procedures have become a necessity in caring for patients. Several nursing procedures taught and practiced in yesteryears have become obsolete as a result of new knowledge of disease pathology and therapy.
The growing body of nursing research further challenges and stimulates nurses to acquire new knowledge and refine their critical thinking skills. Nursing education today aims to provide students a broad knowledge base which would help them provide expert and need-based care to clients with varying health problems. It is, therefore, essential that they master basic theories and skills and become equipped to further develop and refine their abilities to apply analytical thinking in clinical situations.
Nurse educators in India have always been faced with the need to have reference materials suited to present day practice standards. Books which meet the above criteria are written in the context of developed countries where advanced equipments and commercially prepared articles and materials are used for performing most nursing procedures. A procedure manual written in the Indian context, where health care facilities range from most advanced in the tertiary level multi-speciality hospitals in large cities to primary care centers in rural India has been a felt need.
This manual will help in preparing nurses who can demonstrate critical thinking and analytical ability, capable of making adaptations in varying situations. A manual of procedures that is relevant to the present day nursing practice in India has been a need, felt by nurse educators here. The book Clinical Nursing Procedures: The Art of Nursing Practice is an all-in-one compilation of nursing procedures.
Basic, Advanced and Community Health Nursing Procedures are organized and presented in 15 chapters.
The editors and contributors have taken care to present the material in a concise, straight forward and simplified format in an easy to follow language and most importantly in the Indian context. Scientific rationale of every nursing action is included so as to enable nursing students and practicing nurses to use sound clinical judgement while emphasizing cognitive, interpersonal and psychomotor skills needed to carry out nursing procedures. Special considerations are included wherever additional explanations for deviations and adaptations are required.
The contents of the book include nursing procedures to be performed independently by nurses and interdependently by providing assistance to either health care professionals or clients themselves. Most nursing procedures prescribed for undergraduate education by Apex bodies in India are included.
A special feature of this book authored and contributed by Indian Nurses is the many illustrations and colour photographs which would aid to master and reinforce the skills of nursing students as well as practicing nurses.
The editors are confident that this book will prove to be an useful tool for undergraduate students as well as professional nurses working in different settings all over India.
Annamma Jacob
Rekha R
Jadhav Sonali Tarachand
12ACKNOWLEDGMENTS
It takes more than great determination and sustained interest to write a book. For completion of the task, encouragement, support and cooperation of many are essential.
For the production of this book, the editors are deeply thankful to the administration of Bhagwan Mahaveer Jain College of Nursing. The President of Bhagwan Mahaveer Memorial Jain Trust, Mr. Sampathraj Gadia always encouraged us and provided the freedom and the facilities needed to the principal and senior faculty of the college to gather knowledge and teach professional nursing of high quality to their students. The members of BMMJ Trust, Mr Parasmal Bansali and Mr Phoolchand Jain did an excellent job of providing the library in the college with large collection of books and periodicals for reference. This greatly enhanced preparation of materials for the book.
As the idea of putting together all the nursing procedures taught to nursing students in the college emerged in the minds of the first group of faculty, the Chief Executive Officer of the Hospital and College of Nursing, Dr Kishore Murthy offered great encouragement and support. The editors are thankful to Dr Kishore Murthy.
Most of the faculty members who worked in the college of nursing, since its inception in 2003, contributed by way of writing and editing the procedures for the book. The editors thank each one of them for their contribution.
The nursing staff of BMJ Hospital whose practice standards needed updation for providing safe and effective nursing care to patients and the students of BMJ College of Nursing were our inspiration to embark on the task of preparing this manual of nursing procedures.
For the many photographs and illustrations included in the book, college and hospital staffs, their family members, students and patients offered themselves and their efforts, and we record our sincere thanks to everyone of them.
It was Miss Anuradha who in the final stages undertook the job of typing all the material in a professional manner. The preliminary work was done by Mrs Vachala, Mrs Sudheshna Mukherjee and Miss Sylvia Eileen. We thankfully acknowledge their contributions.
Finally but importantly, we once again acknowledge the administration of BMJ College of Nursing, the BMMJ Trust in honour of which this book may be published.